HIV‐1 Subtype as a Determinant of Disease Progression

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Abstract
Although the average time from infection with HIV type 1 (HIV-1) to the development of AIDS is ∼1 decade, the rate of disease progression varies considerably among infected persons. Numerous factors, including plasma HIV-1 RNA level, CD4 cell count, degree of immune activation, age, socioeconomic status, and host genetics, contribute to determining the rate of progression in the individual patient [1]. Intrinsic viral properties, such as coreceptor use and replication capacity, may also influence progression rates. Data have been accumulating to suggest that viral subtype is another contributing factor [2–4]. The report by Kiwanuka et al. [5] in this issue of the journal provides compelling evidence that infection with HIV-1 subtype A (HIV-1A) progresses more slowly than infection with HIV-1 subtype D (HIV-1D) or with recombinant or multiple HIV-1 subtypes.